Date: Name: Spouse's Name: Street Address: City, State, Zip: Home Phone: e-mail: Region(if known) Chapter Check one of the following. Dues include member and spouse One Year United States Membership ($37.00) One Year Foreign Membership ($ 65.00) Introductory 1/2 year membership ($18.50) for new members registering between July 1 and October 1 Student Membership ($12.00) for folks age 18-25 Antique vehicles owned (Optional): (Use ENTER after each vehicle) Junior member names, 18 years old and younger ($5.00 dues per Junior) Send this form, along with your check for dues payable to VMCCA to: VMCCA 7501 Manchester Ave. Kansas City, MO 64138 We also can accept payment by credit card MasterCard, Visa or Discover # Exp. Date:
Date:
Name:
Spouse's Name:
Street Address:
City, State, Zip:
Home Phone: e-mail:
Region(if known) Chapter
Check one of the following. Dues include member and spouse
One Year United States Membership ($37.00)
One Year Foreign Membership ($ 65.00)
Introductory 1/2 year membership ($18.50) for new members registering between July 1 and October 1
Student Membership ($12.00) for folks age 18-25
Antique vehicles owned (Optional): (Use ENTER after each vehicle)
Junior member names, 18 years old and younger ($5.00 dues per Junior)
Send this form, along with your check for dues payable to VMCCA to:
VMCCA
7501 Manchester Ave.
Kansas City, MO 64138
We also can accept payment by credit card
MasterCard, Visa or Discover # Exp. Date:
